What is the Commission for Health Improvement?

The Commission for Health Improvement (CHI) was set up by the 1999 Health Act to perform four core functions: to review the clinical governance* arrangements in every NHS organisation in England and Wales; to review and monitor implementation of national service frameworks in partnership with the Audit Commission; to carry out investigations of NHS health providers where suspected serious service failings had occurred; and to issue advice and information. CHI is not a standard setting body, nor is it likely to become one. Rather, it looks to assess how well the NHS is measuring up to the standards that already exist within the health service and whether trusts have the processes and systems in place to meet those standards within a patient focused agenda.

The setting up of CHI was part of a shift away from measuring performance strictly on the basis of financial and activity targets and towards using a more qualitative, patient focused approach. It was described by the Prime Minister as “the boldest step yet” in the government’s programme to modernise the NHS.

CHI’s powers were extended last year under the NHS Reform and Health Care Professions Act to include:

• The ability to inspect any aspect of the NHS.

• The ability to recommend to the Secretary of State for health when “special measures” should be taken to improve failing performance.

• The establishment of the Office for Information on Healthcare Performance, which will take over the star rating system.

• The publishing of an annual report on the state of the NHS.

The methodology surrounding the first three points are still in development, although it is envisaged that the new inspection regime will be more flexible to individual trusts’ specific needs. The first commentary on CHI’s findings …